Amnioinfusions to Treat Early Onset Anhydramnios Caused by Bilateral Renal Agenesis : Potter’s Syndrome
DOI:
https://doi.org/10.25077/aoj.6.1.89-97.2022Abstract
Introduction: Anhydramnios is a very small amount of amniotic fluid where the MVP measurement is 2cm by ultrasound. The most common cause of anhydramnios that persists into the second trimester of pregnancy is bilateral renal agenesis. Bilateral renal agenesis is closely related to Potter's Syndrome. Potter's syndrome is a picture of reduced amniotic fluid regardless of the cause. The most common cause of newborn death in cases of anhydramnios is pulmonary hypoplasia. Amnioinfusion is an action of adding fluid into the amniotic cavity which is expected to reduce uterine pressure due to anhydramnios and maintain alveolar distension to increase fetal lung growth.
Objective: The aim of this case report is to share amnioinfusion on anhydramnios.
Case Report: A 26-year-old woman G3P1A1H1 gravid 27-28 weeks was referred to the fetomaternal polyclinic of RSUP M. Djamil Padang with suspicion of anhydramnios caused by bilateral renal agenesis. Physical and obstetric examinations were found to be within normal limits. On ultrasound examination, there was no amniotic fluid, so MVP was difficult to assess, no fetal kidney and bladder were seen, so it is suspected that this is a bilateral renal agenesis disorder and leads to Potter's Syndrome. The patient was subjected to amnioinfusion to prevent contractures and pulmonary hypoplasia in the fetus. From the first amnioinfusion, the MVP increased to 2.99 cm. Monitoring and amnioinfusion are carried out periodically until the fetus is viable to be born
Conclusion: Amnioinfusion in bilateral renal agenesis is useful for assisting diagnosis and as a preventive therapy for pulmonary contractures and hypoplasia in the fetus as well as increasing life expectancy when the fetus is born.
Keywords: Bilateral Renal Agenesis, Anhydramnios, Amnioinfusion, Potter's SyndromeReferences
Abuhamad A. Ultrasound Obstetric and Gynecology , Chapter 9 : Amniotic Fluid Assessment.: Davies Publishing, Incorporated; 2014. 178-84
Elizabeth., Angie. OH, Rodrigo. JJLM, Ruanoe, Meredith., Ahmet. A, et al. Amnioinfusions to Treat Early Onset Anhydramnios Caused by Renal Anomalies: Background and Rationale for the Renal Anhydramnios Fetal Therapy Trial. Fetal Diagn Ther 2019;45:365–72.
Chauhan N, Namdeo P, JN. Evidence Based Management of Oligohydramnios. . Modi Open Access Journal of Gynecology Medwin Publishers 2018;Vol.3(3).
Cunningham. Williams obstetrics, 25 th, Chapter 11: Disorders of Amniotic fluid.: McGraw-Hill Education; 2018.
Fred E, Laulom B, Cassart M, Eurin D, Nassez A, Hall M. Ultrasonography In Obstetrics and Gynecology; Callen. . United States of America Elsevier:; 2008.
Vikraman SK, Chandra V, Balakrishnan B, Batra M, Sethumadhavan S, Patil SN, et al. Impact of antepartum diagnostic amnioinfusion on targeted ultrasound imaging of pregnancies presenting with severe oligo-and anhydramnios: An analysis of 61 cases. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2017;212:96-100.
Ross MG, Beall MH. Physiology of amniotic fluid volume regulation. UpToDate, Wolters Kluwer. 2017;Mey.
Marva Moxey-Mims MD, F.A.S.N.1 and Tonse N. K. Raju, M.D., D.C.H. Anhydramnios in the Setting of Renal Malformations: The National Institutes of Health Workshop Summary. Obstet Gynecol. 2018;131 (6):1069–79.
Bhandari J, Thada PK, Sergent SR. Potter Syndrome. StatPearls 2020.
Tisekar, Owais R, Kumar A. Hypoplastic Lung Disease. StatPearls 2020.
Yusrawati, Andi Friadi. Diagnosis Prenatal Hidronefrose dengan Ultrasonografi (laporan kasus). INAJOG, 2007;31 (1): 42-8
Cunningham GF. 2018. Disorders of Amniotic fluid. Williams obstetrics, 25th ed., Chapter 11, Hal: 236-238.
Micheal GR, Marie HB. 2017. Physiology of Amniotic Fluid Volume Regulation. UptoDate. Wolters Kluwer.
Moise KJ Jr; Toward consistent terminology: assessment and reporting of amniotic fluid volume. Semin Perinatol. 2013 Oct;37(5):370-4. doi: 10.1053/ j.semperi. 2013.06.016.
Cicily TJ, Sherin S, Anitha KG.2017. Effect of hydration therapy on oligohydramnios. Int. J. Reprod Contracept Obstet Gynecol. May;6(5):1800-1805.
Krishna J, Nisha S, Sachin P. 2013. Maternal and Fetal Outcome in Oligohydramnios : a studi 100 kasus. International Journal of Medical Science and Publoic Helath. Vol 2; 3.
Royal Cornwall Hospitals. 2016. Amniotic Fluid Volume Abnormality : Diagnosis and Management.
Sonkhya P, Gupta N, Mittal P. 2017. Pregnancy Outcomes of Oligohydramnios by Ultra Sonography (USG): Penelitian Case Control; International Multispecialty Journal of Health (IMJH). Vol.3(2).
Elizabeth AD, Everett FM. 2013. Amniotic Fluid as a Vital Sign for Fetal Wellbeing. AJUM 16(2)
Nimra Dad, Mandy Abushama, Justin C. Konje, and Badreldeen Ahmed. 2016. What is the role of amnioinfusion in modern day obstetrics?. J Matern Fetal Neonatal Med; 29(17): 2823–2827
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Rizka Fadhillah Yusra
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright
Authors who publish with this journal agree to the following terms:
- Authors retain the copyright of published articles and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
License:
Andalas Obstetrics and Gynecology Journal (AOJ) is published under the terms of the Creative Commons Attribution 4.0 International License. This license permits anyone to copy and redistribute this material in any form or format, compose, modify, and make derivatives of this material for any purpose, including commercial purposes, as long as they credit the author for the original work.
